Urinary Tract Infection

Question 1

What are the 2 forms of UTI?

Answer 1

Cystitis
Pyelonephritis

Question 2

What is cystitis?

Answer 2

Infection resulting in inflammation of the baldder

Question 3

What is pyelonephritis?

Answer 3

When the infection spreads up tot the kidneys

Question 4

What is the main organsim that causes UTI’s?

Answer 4

E.coli

Question 5

What are the main presentifn symptoms of cystitis?

Answer 5

Frequency
Urgency
Dysuria
Suprapubic pain

cloudy/offensive smelling urine

Question 6

What can be a sign of a UTI in elderly?

Answer 6

Confusion

Question 7

What is used to diagnose a UTI?

Answer 7

Urine dipstick

Question 8

What would you look for in a urine dipstick of someone with a UTI?

Answer 8

Nitrites
Leukocytes

Question 9

In who should a urine dipstick NOT be used for diagnosis of a UTI?

Answer 9

Women > 65 years
Men
Catheterised patients

Question 10

What else can be used to diagnose a UTI?

Answer 10

Urine culture (MSU)

Question 11

Fow whom would you do a urine (MSU) culture to diagnose a UTI, rather than a urine dipstick?

Answer 11

women aged > 65 years
recurrent UTI (2 episodes in 6 months or 3 in 12 months)
pregnant women
men
visible or non-visible haematuria

Question 12

What is classed as a recurrent UTI?

Answer 12

2 episodes in 6 months
3 episodes in 12 months

Question 13

What is the problem with catheter associated UTI’s?

Answer 13

They are more significant and difficult to treat

Question 14

What are the main causes/RF of a UTI?

Answer 14

Women- shorter ureter
Pregnancy
Sex- spread bacteria around perineum
Catheter

Question 15

What are the main symptoms of pyelonephritis?

Answer 15

fever, rigors
loin pain
nausea/vomiting
Haematuria

Question 16

What is the main investigation for pyelonephritis?

Answer 16

Urine culture (MSU)
Urine diptick
FBC- WCC
U and E’s- Renal impairment

Question 17

What imaging mght you consider for pyelonephritis?

Answer 17

Ultrasound- check for hydronephrosis

Question 18

What is the management of pyelonephritis?

Answer 18

Admit
IV antibiotics

Question 19

What IV antibiotics would be given for pyelonephritis?

Answer 19

Broad-spectrum cephalosporin (main)
Or quinolone

Question 20

How long should IV antibiotics be given for pyelonephritis?

Answer 20

10 days

Question 21

Who can’t be given cephalosporin or quinolone?

Answer 21

Pregnant women

Question 22

What is the medical management of cystitis?

Answer 22

Nitrofuratoin or trimethoprim

Question 23

What is an alternative to Nitrofuratoin or trimethoprim?

Answer 23

Amoxicillin

Question 24

How long are antibiotics given for an uncomplicationed lower UTI?

Answer 24

3 days

Question 25

How long are antibiotics given for men, pregnant women or catheter related UTIs?

Answer 25

7 days

Question 26

What is the first line medication for a UTI in pregnancy?

Answer 26

Nitrofuratoin (7 days)

Question 27

What is the problem with nitrofuratoin?

Question 28

What is the problem with nitrofuratoin in pregnancy?

Answer 28

Avoid in the third trimester as it is linked with haemolytic anaemia in the newborn.

Question 29

What is the problem with trimethoprim in pregnancy?

Answer 29

Avoid in the first trimester or if they are on another medication that affects folic acid

Question 30

What medications are usually used secondary to nitrofuratoin in pregnancy?

Answer 30

Cefalexin or amoxicillin